Non-covered share of medical spending

Published Draft: kept out of search until the figures are confirmed

The non-covered share of medical spending in Korea is published by the National Health Insurance Service alongside the health insurance coverage rate.

Both appear by year with their definitions.

On this page

What share of medical spending is non-covered?

The yearly share is shown below once the NHIS figures are collected.

Non-covered share of medical spending and coverage rate (Non-covered share of medical spending, To be filled after the reference date is confirmed)
YearNon-covered shareCoverage rate
To be filled after the reference date is confirmed

What is the difference between covered and non-covered care?

Covered care follows prices set by the insurance system; non-covered care is priced by each institution.

Covered, selectively covered, non-covered and full self-pay
CategoryWho decidesWhat the patient pays
Covered (benefit)Ministry of Health benefit standardsThe statutory co-payment share
Selectively coveredMinistry of Health notice on selective benefitsA higher co-payment share than regular benefits
Non-coveredListed as non-covered; price set by the institutionThe full price set by the institution
Full self-payBenefit item used outside the set conditionsThe full benefit price

What is the health insurance coverage rate?

The share of total medical spending paid by health insurance; the rest is co-payments and non-covered charges.

How is the non-covered price data collected?

Institutions report their non-covered prices under a Ministry of Health notice, and HIRA publishes them; this site aggregates the published file.

The reporting and disclosure standards are set by the Ministry of Health and Welfare notice on non-covered medical fees. HIRA publishes item-level prices by institution. This site downloads the published file, keeps only the item, region, hospital type and price columns, and groups them before anything is saved.

The share of spending comes from NHIS publications, not from the disclosure file; the exact table name is confirmed when the snapshot is collected.

What can this price data not tell you?

It shows disclosed prices, not what any one patient will pay, and it cannot show the quality of care.

  • Disclosed prices can differ from the amount actually billed.
  • The scope of disclosed items and institutions changes from year to year.
  • Price and treatment results cannot be linked using this data.

Korea Non-covered Medical Price Statistics shows the distribution of prices disclosed to HIRA, not the price at any particular institution, and it introduces or recommends no hospital. The relationship between price and treatment results cannot be judged from this data. Disclosed prices can differ from the amount actually billed. For a specific institution, use HIRA’s official non-covered price service.

What basis are these numbers on?

Data used and reference dates
SnapshotSourceReference dateRetrievedSite calculation
Non-covered share of medical spendingNational Health Insurance Service (NHIS)To be filled after the reference date is confirmedTo be filled after the reference date is confirmed-

What else do people ask about non-covered share of spending?

How much of medical spending in Korea is non-covered?

NHIS publishes the share each year. This page shows it with the reference year once collected.

Who publishes the coverage rate?

The National Health Insurance Service.

Does the share include dental and traditional medicine?

The scope follows the NHIS definition for each year, noted in the basis section.

Why does the share matter to patients?

It shows how much of spending falls outside insurance on average.

Is this the same as my own out-of-pocket cost?

No. It is a national average and individual costs vary widely.

Where do these numbers come from?

  1. National Health Insurance Statistical Yearbook · National Health Insurance Service (NHIS) · Annual · Primary source
  2. National Health Insurance Act · Korea Law Information Center · Primary source

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